Young adults including university students are at high risk of acquiring HIV due to their risky sexual practices. The aim of this study was to determine the prevalence of risky sexual behaviours amongst regular undergraduate students in Jigjiga University. The researcher used a quantitative, univariate cross-sectional descriptive study. Two hundred and thirty six (236) students were selected using a simple random sampling technique. Data were collected using a standardised structured questionnaire. The study revealed that 70.53% of respondents were sexually experienced. Majority (54.8%) of the sexually experienced respondents were sexually active within 3 months of the study. Up to 30.14% of sexually experienced respondents have had sex with a person other than their current partner in the past 12 months. Only 59.6% of the sexually experienced respondents used condom in their most recent sexual engagement. The findings of this study showed that university students are involved in sexual behaviours that may increase their risk of contracting HIV infection. Based on the above results, researchers recommended the designing of interventions which are contextually relevant to Jigjiga University to mitigate risky sexual practices amongst university students.

Background: The diagnosis of HIV is life-changing that requires people not only to deal with the disease but also to cope with the stigma attached to HIV. People living with HIV (PLWH) as well as their close family members (CFM) are stigmatised; however, CFM also stigmatise PLWH. This interaction affects the relationship between PLWH and their CFM.

Aim: To explore and describe the experiences of PLWH and CFM during and after a community-based HIV stigma reduction intervention in both an urban and rural setting in the North-West.
Method: A qualitative description approach through in-depth interviews was used in both settings. Purposive sampling was used for the PLWH and snowball sampling for the CFM. Data was analysed using open coding.
Results: Both urban and rural groups gained a richer understanding of HIV stigma and how to cope with it. The relationships were enriched by PLWH feeling more supported and CFM realising how they stigmatised PLWH and that they should be more supportive. Leadership was activated in PLWH and CFM through the stigma reduction project that they participated in.
Conclusion: No significant differences were found between rural and urban communities,thus the intervention can be implemented with similar results in both settings. The intervention showed positive outcomes for both PLWH and CFM. Bringing PLWH and CFM together during an intervention in an equalised relationship proved to be useful as PLWH felt more supported and CFM showed much more compassion towards PLWH after the intervention.

This study focuses on one aspect of a more extensive SANPAD-funded HIV stigma reduction research project. The study addresses not only the continuous burden of HIV stigma, but more specifically on the low rate of participation in healthcare opportunities and HIV stigma reduction interventions by people living with HIV (PLWH) This study tested both change-over-time in HIV stigma experiences of PLWH and change-over-time in the HIV stigmatisation behaviour of people living close to them (PLC) in an urban and rural setting in the North-West in South Africa. These aspects were measured before and after the comprehensive community-based HIV stigma reduction intervention. A quantitative single system research design, with a pre-test and four repetitive post-tests, and purposive voluntary and snowball sampling were used. Findings did not indicate significant differences between urban and rural settings, but demonstrated some significance in changeover-time in the HIV stigma experiences of PLWH as well as the HIV stigmatisation behaviour of PLC after the intervention. Recommendations include the continuation of this intervention, following the same guidelines that were implemented during the study.

Background: Selection criteria used to admit students to a radiography programme at the Central University of Technology (CUT) included academic criteria, as well as the General Scholastic Aptitude Test (GSAT) and Self-directed Search (SDS) Questionnaire.

Aims and objectives: The aim of the study was to identify which selection criteria were predictors of academic success in the first year of study. As a four year Bachelor's degree in Radiography (480 credits) was to replace the three year National Diploma (NDip) in Radiography (360 credits), selection criteria would come under review.
Design and method: Data from 130 students were gathered in a retrospective quantitative study. Data were edited, categorised and summarised. A statistical analysis was undertaken to identify which selection criteria predicted academic success in the first year of study.
Results: Statistics showed that the matriculation Admission Points Score (National Senior Certificate/NCS APS) and core matriculation subject results in Mathematics, Physical Sciences and English were adequate predictors for first-year academic success, and the subjects Life Sciences for the NSC and Biology for the Senior Certificate (SC), showed strong predictive values for first-year academic success. According to the statistical analysis, the GSAT and SDS Questionnaire did not contribute any significant information which could predict academic success.
Conclusion: Matriculation marks and NSC APS were adequate predictors for academic success, with a focus on Life Sciences or Biology marks as the strongest predictor. The usefulness of the GSAT and SDS Questionnaire could be questioned, and a recommendation was made to replace these tests with alternative student selection methods.

Background: Caring forms the core component of nursing. The history of the nature of caring in South Africa is non-specific and is unknown. The impact of nurse and activist Albertina Sisulu known as the Mother of the Nation e has the potential to offer unique insights into what could be the context of caring for nurses.

Aims: The study aimed at 1) critically synthesising the available evidence of caring as portrayed by Albertina Sisulu within the South African context, and 2) interpreting Sisulu's work within the Ubuntu philosophy as a framework for nursing and caring.
Method: An integrative review was completed using Whitte more and Knafl's framework. Key electronic databases, selected references and web-based search engines were scoured for articles meeting the inclusion criteria. This systematic and iterative approach yielded18 non-research reports related to Sisulu; eight reports (three research, five non-research) related to ubuntu and nursing. Data was extracted that related to relevant and conclusive new and innovative practices in caring.
Results: The findings provided a context for practice guidelines of caring concerning knowledge and critical thinking about caring by nurses. Two primary factors emerged that demonstrated a culture of caring as seen through the prism of Sisulu's life: devoted dancer and creation of a healing environment. These factors also reflect African ubuntu principles, where the focus is on the relationships between people and how these relationships could be conducted.
Conclusions: Ubuntu and Sisulu's approach to caring have much to offer for the nursing profession in terms of developing of new directions for nursing pedagogy, curriculum, practice patterns, and policies that emphasise caring constructs.

Background: Using best evidence to inform practice is the cornerstone of quality patient care, and requires spread, uptake, implementation and roll-out of best practices. Kangaroo mother care (KMC) was used as a best practice which has been partly rolled-out in South Africa. In order for successful roll-out of best practices, it is important to understand what health professionals perceive as requirements for the rolling-out process. However, no published research was found on requirements for rolling-out a best practice in the South African context.

Purpose: of the research: To explore and describe the perspectives of health professionals on the requirements for the rolling-out process of KMC as a best practice in South Africa.
Methodology: Twelve semi-structured individual interviews were conducted in 2012 with health professionals from various South African healthcare levels, involved in the implementation and the rolling-out process of kangaroo mother care. Content analysis were guided in terms of the four requirements for roll-out of best practices, identified in Edwards and Grinspun's Evidence Informed Model of Care.
Results: The requirements for the successful roll out of best practices mentioned by the participants in this study concur with the requirements of Edwards and Grinspun: personal alignment and protocol/policy alignment with the best practice; a roll-out plan; leadership; and supporting and reinforcing structures such as: resources, communicating, education and development regarding the best practice, and the organisational structure. The requirements were identified at four different levels: individual level (e.g. the nurse and medical specialists), management level (of the hospital), provincial level and national level.

Background: Pharmacovigilance (PV) as a means of ensuring drug safety is an essential component of the process ensuring that the risk of drug use does not outweigh the benefit. Pharmacists are valuable in collecting PV information, but not many studies explored the knowledge, perceptions and practices of both community and hospital pharmacists towards the practice of PV.

Objectives: The aim of the study was to explore the knowledge, perceptions and practise of PV amongst the pharmacists in a selected district of North West Province, South Africa.
Method: A cross sectional study was conducted amongst pharmacists in a selected district of the North West province, using a pre-tested questionnaire. Descriptive statistics were used to analyse the results including ANOVA testing.
Results: One hundred and two pharmacists (68.9%) completed the questionnaire. Although familiar with the concept of PV, pharmacists knowledge scores were low. Pharmacists agreed that PV is a useful tool, but perceived the PV authorities to be distant and remote. Although more than 90% indicated that all adverse drug reactions should be reported, only 44.1% indicated that they have reported adverse drug reactions (ADRs). Only 6.7% of pharmacists were satisfied with feedback received from authorities after reporting an ADR. Barriers were cited that prevented them from reporting ADRs. Over 80% indicated they would participate in further PV training.
Conclusion: The majority of pharmacists are familiar with the concept of PV, but less than half reported any ADR. They are willing to participate in PV processes but are unsure what their exact role playing should be. More than half indicated that they would like to see improvements to the current PV system in South Africa. The majority are prepared to undergo further education to improve their PV knowledge.

Background: Community care workers (CCWs) inhabit a central role in the management of tuberculosis (TB) patients in South Africa. CCWs attend training courses, but training is not standardised at either the national or provincial level.

Objective: To explore perceptions of CCWs of their role in TB care and TB information needs.
Methods: CCWs working with TB patients were recruited from Grahamstown Hospice and local primary healthcare clinics in Grahamstown. Focus group discussions and semi-structured interviews were conducted with 14 CCWs using a question guide. Data were thematically analysed.
Results: Three themes emerged from data analysis. Firstly, altruism was identified as the major motivational factor, with a desire to help others often stimulated by previously caring for sick relatives. Some CCWs had experienced being patients needing care, which motivated them to become involved in offering patient care. Secondly, CCWs reported great fulfilment and pride in their work as they believed they made a meaningful impact on patients' lives and in the surrounding community, and were respected for this contribution. Thirdly, most identified a need for further training and access to additional information about TB, particularly MDR- and XDR-TB, in order to reinforce both their own knowledge and to educate patients about drug-resistant TB.
Conclusion: CCWs were motivated and proud of their contribution to TB patient management and the education they provided to patients and to lay community members. Ongoing training was identified as a need, along with access to quality information materials to improve their knowledge and facilitate patient counselling.

Background: Observation is an important approach to care that is commonly used in inpatient learning disability services to prevent self-harming behaviours. It is often implemented when there is a perceived increase risk of self-harm. Most nurses who implement observation have little or no training in the use of this practice. The literature on this subject is also biased towards mental health settings with learning disability services much neglected.

Aim: To explore nurses' knowledge and understanding of the use of observation on patients who self-harm in a learning disability service in the United Kingdom.
Design and methods: This study adopted a qualitative approach, and utilised interpretative phenomenological analysis as a design and as a tool of analysis. The study was conducted in a secure learning disability service in the United Kingdom. Data were obtained from registered nurses using individual interviews (n 1/4 20) and focus groups (n 1/4 3 x 5 1/4 15). Data were analysed thematically using the principles of interpretative phenomenological analysis.
Results: Three superordinate themes emerged from data analysis: 1) observation: its meaning, 2) observation: does it prevent self-harm? 3) Observation: making it work.
Conclusion: Observation is a useful practice in in-patient learning disability services, which can be used to prevent or reduce the incidence of self-harm in these settings. This approach should therefore be an integral part of nurses' daily therapeutic activities in inpatient learning disability services.

Background: Education and experience are important components in the ability of occupational health nurses (OHNs) to promote high-quality care and competence. OHNs will increasingly require the skills and knowledge to base care on best evidence, to use critical thinking and demonstrate advanced leadership and decision-making skills to develop and enhance services in a more complex and diverse occupational healthcare environment.

Objective: The purpose of this study was to identify the needs for professional development of the OHN in the occupational health setting.
Method: An explorative, descriptive, contextual generic and qualitative research method was used in this study. The purposive sampling method was used as the OHNs surveyed described their personal need for professional development in the occupational health setting. Data was collected by means of semi-structured individual interviews. Eight interviews were done by an interviewer who held a doctoral degree in community health nursing and a qualification in occupational health and was affiliated with a private occupational health institution at the time of the study. The interviews were conducted during August 2012.
Results: The OHNs reported that professional development needs have to be identified by the OHNs. Short courses need to be designed by training institutions and should be attended by the OHNs to improve their operational functioning on a day-to-day basis in the occupational health setting. The OHNs experienced that their role and function in the workplace were not valued by their managers. The results of this study revealed four major themes, namely constraints hindering the OHN in developing professionally, positive aspects identified by the OHNs regarding the need for professional development, professional development needs of the OHN and suggestions of how to meet the OHNs' professional development needs.
Conclusion: There is a need for OHNs to identify their professional development needs and recommendations were made to meet these needs.

Background: The Picture Archiving and Communication System (PACS) has led to an increase in breached health records and violation of patient confidentiality. The South African constitution makes provision for human dignity and privacy, virtues which confidentiality seeks to preserve. Confidentiality thus constitutes a human right which is challenged by the use of technology. Humans, as managers of information technology, constitute the weakest link in safeguarding confidentiality. Nonetheless, it is argued that most security breaches are non-intentionally committed by well-meaning employees during routine activities.

Objective: The purpose of this article is to explore the nature of and reasons for confidentiality breaches by PACS users in a South African context.

Methods: A closed-ended questionnaire was used to collect quantitative data from 115 health professionals employed in a private hospital setting, including its radiology department and a second independent radiology department. The questionnaire sought to explore the attitudes of participants towards confidentiality breeches and reasons for such behaviour.

Results: Breach incidences were expressed as percentage compliance and classified according to the nature and reasons provided by Sarkar's breach classification. Cross tabulations indicated a statistical significance (p < 0.00) between the expected and observed confidentiality practices of participants and also the adequacy of training, system knowledge and policy awareness.

Conclusion: Our study supports previous findings that, in the absence of guidelines, most security breaches were non-intentional acts committed due to ignorance. Of concern are incidents in which sensitive information was intentionally shared via social media.

Higher cognitive skills are essential competencies for nurses joining the technologically and increasingly complex health care environment to provide safe and effective nursing care. Educators and clinical facilitators have recognised that newly qualified nurses do not meet the expectations for entry level clinical judgement and are held accountable for finding adequate learning experiences as preparation for such practice demands. An explorative and descriptive qualitative design was followed in this study to reach an understanding of clinical judgement in the clinical nursing environment from the perspective of professional nurses. Eleven professional nurses (n ¼ 11) working at primary health care clinics, public and private hospitals participated voluntarily. Data was collected by means of the “World Cafe” method, incorporating a combination of techniques such as interviewing, discussions, drawings, narratives and reflection. The focus was on professional nurses' knowledge of the meaning of clinical judgement and factors influencing the development of clinical judgement in the clinical environment. Qualitative thematic content analysis principles were applied during data analysis. The findings were integrated with the relevant literature to culminate in conclusions that should add to the knowledge base of clinical judgement as an essential skill for improving autonomous and accountable nursing care.

Purpose: This study serves to determine the effectiveness of either chiropractic spinal manipulative therapy to the thoracic spine or stretch and strengthening exercises (stretching the pectoralis major muscle and strengthening the rhomboid, middle and inferior trapezius muscles) versus the combined treatment of chiropractic spinal manipulative therapy to the thoracic spine in conjunction with stretch and strengthening exercises.

Method: A randomised study design with thirty female participants between the ages of twenty and thirty nine was selected. Group 1 (n ¼ 10) received chiropractic spinal manipulative therapy to the thoracic spine. Group 2 (n ¼ 10) received chiropractic spinal manipulative therapy to the thoracic spine as well as stretch and strengthening exercises i.e. stretching the pectoralis major muscles and strengthening the rhomboid, middle and inferior trapezius muscles. Group 3 (n ¼ 10) received stretch and strengthening exercises. The stretch and strengthening exercises were performed in the consultation rooms to ensure that the participants were complying with the treatment and doing the exercises properly. The study consisted of seven consultations for Group 1 (they received treatment once a week for six weeks) and for Groups 2 and 3 there were nineteen consultations (they received three treatments a week for six weeks). Objective data was recorded at the beginning of the first, fourth and seventh consultations for Group 1, and the first, tenth and nineteenth consultations for Groups 2 and 3. On the seventh consultation (for Group 1) and nineteenth consultation for Groups 2 and 3, only data collection was done. Objective data were obtained by using the Flexicurve® Ruler measurements for the angle of kyphosis. Visual analysis was done by taking lateral (sagittal) view photographs at the beginning of the initial and final consultations.

Results: Statistical analysis revealed significant statistical changes for the intragroup results for all three groups. No significant statistical difference was found between the groups for the inter-group analysis.

Background: Blood products are an expensive and scarce resource with inherent risks to patients. The current knowledge of rational blood product use among clinicians in South Africa is unknown.

Purpose of research: To describe the level of clinicians' knowledge related to all aspects of the ordering and administration of blood products from the South African Blood Services for peri-operative patients at a tertiary hospital.

Method: A self-administered survey was distributed to 210 clinicians of different experience levels from the departments of Anaesthesiology, General Surgery and Trauma, Orthopaedic Surgery and Obstetrics and Gynaecology at the study hospital. The questions related to risks, cost, ordering procedures and transfusion triggers for red cell concentrate (RCC), fresh frozen plasma (FFP) and platelets.

Results: A total of 172 (81.90%) surveys were returned. The overall mean for correctly answered questions was 16.76 (±4.58). The breakdown by specialty was: Anaesthesiology 19.98 (±3.84), General Surgery and Trauma 16.28 (±4.05), Orthopaedic Surgery 13.83 (±4.17) and Obstetrics and Gynaecology 15.63 (±3.51). Anaesthesiology performed better than other disciplines (p < 0.001) and consultants out-performed their junior colleagues (p < 0.001). Seventy percent correctly identified triggers for RCC transfusion and 50% for platelets. Administration protocols were correctly defined by 80% for RCC and FFP just over 50% for platelets. Thirty eight percent of respondents deemed infectious and non-infectious risk sufficient to obtain informed consent. Knowledge of costs and ordering was below 30%.

The goal of this study was to explore and describe the experience of parents regarding the primary health care (PHC) management of their children's atopic eczemain a Gauteng district. A qualitative, explorative, descriptive, contextual embedded single case study design was employed. Data were collected through semi-structured individual interviews, field notes and direct observation until saturation occurred; analysed according to Tesch's steps of descriptive data analysis. Trustworthiness and ethical measures were used and were employed. Three themes were identified. Management challenges, the second theme with sub-themes: drug management, knowledge levels of PHC clinicians, health education and financial challenges, will be discussed.

Background: Recreational noise exposure, including personal music device use (PMD), has become a growing public health concern, as it may potentially result in the development of hearing difficulties.

Objectives: The aim of the study was to determine the differential impact and short-term effects of simultaneous cardiovascular workout and PMD use on the outer hair cell (OHC) function of young adults.

Method: A quantitative research approach was followed. In this study a pre-test post-test approach was used and twelve subjects participated in three 1 h testing conditions with altered variables including: (i) exposure to PMD use in isolation, (ii) exposure to cardiovascular workout in isolation, and (iii) simultaneous exposure to the latter mentioned. Distortion product otoacoustic emissions (DPOAEs) were conducted pree and postexposure for each testing condition as primary indicator of cochlear responses. The process consisted of a cycling procedure through the preset stimulus frequency sequence, measuring the 2f₁ef₂ (75e70 dBSPL) and constructing a plot of DPOAE levels as a function of frequency.

Results: Individual testing conditions did not result in statistically significant changes of the DPOAE response, however a significantly different profile in the DPOAE response level increase/decrease for the higher frequencies (6e8 kHz) was obtained when comparing the different sessions. Exposure to cardiovascular workout condition in isolation indicated a clear trend of an increased DPOAE response level between the pre-exposure and postexposure testing from 2 kHz to 8 kHz with a maximum increase at 6 kHz. Both the music-only condition and the combined condition resulted in a clear trend of decreased DPOAE response amplitudes between the pre-exposure and post-exposure testing for the higher frequencies.

Despite efforts to scale up access to antiretroviral therapy (ART), particularly at primary health care (PHC) facilities, antiretroviral therapy (ART) continues to be out of reach for many human immunodeficiency virus (HIV)-positive children in sub-Saharan Africa. In resource limited settings decentralisation of ART is required to scale up access to essential medication. Traditionally, paediatric HIV care has been provided in tertiary care facilities which have better human and material resources, but limited accessibility in terms of distance for caregivers of HIV-positive children. The focus of this article is on the experiences of caregivers whilst accessing ART for HIV-positive children at PHC (decentralised care) facilities in Nelson Mandela Bay (NMB) in the Eastern Cape, South Africa. A qualitative, explorative, descriptive and contextual research design was used. The target population comprised caregivers of HIV-positive children. Data were collected by means of indepth individual interviews, which were thematically analysed. Guba's model was used to ensure trustworthiness. Barriers to accessing ART at PHC clinics for HIV-positive children included personal issues, negative experiences, lack of support and finance, stigma and discrimination. The researchers recommend standardised programmes be developed and implemented in PHC clinics to assist in providing treatment, care and support for HIVpositive children.

Background: With the introduction of the phlebotomist technician-certification programme in South Africa, nurses' phlebotomy competence, an acquired skill during basic training, was questioned. Various studies indicate that the majority of errors occur during the collection phase, causing negative outcomes for the patient.

Objective: Despite in-service training, samples were rejected and linked to the nurse phlebotomist's sample collection technique. The purpose of this study was to establish if nurses' phlebotomy techniques could be improved through a workplace-training programme in the attempt to improve the quality of the test results.

Method: The methodology used was a quantitative, experimental, pilot intervention study, based on a one group pre-test - post-test design. Data was collected by means of peer video recordings of the nurses (n ¼ 20) based at outpatient departments of the laboratory. Independent evaluators evaluated the recordings against criterion-based observational checklists.

Results: Compliance to standards on the venepuncture procedure was identified during the pre-test, with an average score of 61.9%. The training programme, developed to address all deviations from the standards, proved to be effective as the post-test compliance score was 85%.

Conclusion: The reason for improving nurses' phlebotomy skills is to ensure accurate results that will assist clinicians caring for their patients. The results suggest that knowledge and skills were acquired, however further investigations are needed for guidance in the standardisation of training programmes and at what intervals should these training programmes be presented.

Background: One of the risks associated with low physical activity levels is the insufficient development of motor proficiency, which in turn has an impact on participation in physical activity and sport during adolescence.

Objectives: To determine the relationship between motor proficiency and physical activity levels in adolescent Senior Phase learners in Potchefstroom, South Africa. No literature exists on the relationship between motor proficiency and physical activity levels among South African adolescents.

Method: A total of 239 13- to 14-year-old learners were assessed using the Bruininks eOseretsky Test of Motor Proficiency 2 (BOT-2) for motor proficiency, and the International Physical Activity Questionnaire (IPAQ) for physical activity levels. Data analysis included descriptive statistics, Spearman correlation coefficients and effect sizes.

Results: Statistically and practically significant correlations were found between the total BOT-2 score and the physical activity levels of the total group, as well as the boys and the girls respectively. Fine motor coordination correlated with physical activity levels in the girls, while manipulation coordination correlated with the physical activity levels of the total group and the boys. The body coordination skill of jumping in place and the strength test items showed strong correlations with physical activity in all the groups.

Conclusion: The motor skills of Senior Phase learners, especially coordination and strength skills, should be developed and maintained in the Physical Education curriculum to enhance physical activity levels.